Provider Demographics
NPI:1871850990
Name:DAGATA, LINDSEY ERIN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:LINDSEY
Middle Name:ERIN
Last Name:DAGATA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 NESBIT AVENUE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119
Mailing Address - Country:US
Mailing Address - Phone:203-466-6850
Mailing Address - Fax:203-466-5848
Practice Address - Street 1:451 N HIGH ST
Practice Address - Street 2:
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06512-1555
Practice Address - Country:US
Practice Address - Phone:203-466-6850
Practice Address - Fax:203-466-5848
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004389235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist